When a Teenager Is in Mental Health Crisis: A Parent's Guide

What a mental health crisis can look like in a teen

Mental health crises in teenagers do not always announce themselves dramatically. Some teens express suicidal thoughts directly; others give subtle signals — giving away meaningful possessions, making comments about being a burden, sudden calm after a period of severe depression, or increased risky behavior 2Ref 2American Academy of Child and Adolescent Psychiatry (2024).Suicide in Children and Teens (Facts for Families No. 10).Suicide is the 2nd leading cause of death ages 15–24; warning signs including giving away possessions and sudden calm after depression; directly asking about suicidal thoughts is recommended. Other crisis presentations include acute psychosis (confused thinking, paranoia, hallucinations), extreme panic or dissociation, or a teen who is completely unable to be engaged or calmed. Suicide is the second leading cause of death for people aged 15 to 24 in the United States, which is why crisis warning signs warrant prompt, serious attention 2Ref 2American Academy of Child and Adolescent Psychiatry (2024).Suicide in Children and Teens (Facts for Families No. 10).Suicide is the 2nd leading cause of death ages 15–24; warning signs including giving away possessions and sudden calm after depression; directly asking about suicidal thoughts is recommended. Any situation where a teen may harm themselves or where a parent is genuinely frightened warrants immediate professional support.

The 988 Suicide and Crisis Lifeline

988 is the national Suicide and Crisis Lifeline — available by call or text, 24 hours a day, 7 days a week 1Ref 1Substance Abuse and Mental Health Services Administration (SAMHSA) (2025).988 Suicide & Crisis Lifeline.988 Lifeline: launched July 2022, 24/7 call/text/chat, 200+ local crisis centers, 240+ languages, 8+ million contacts in 2025; for any mental health crisis not just suicide attempts. Launched in July 2022, the line is funded by SAMHSA and provides access to trained crisis counselors through a network of over 200 local crisis centers. It is available in English, Spanish, and via interpreter in more than 240 languages.

988 is not only for imminent suicidal attempts — it is for any mental health crisis, including parents who are unsure whether their teen is safe. Using it as a first call can help avoid unnecessary emergency department visits or, conversely, help parents understand when the ED is the right place. In 2025 alone, 988 received more than 8 million contacts 1Ref 1Substance Abuse and Mental Health Services Administration (SAMHSA) (2025).988 Suicide & Crisis Lifeline.988 Lifeline: launched July 2022, 24/7 call/text/chat, 200+ local crisis centers, 240+ languages, 8+ million contacts in 2025; for any mental health crisis not just suicide attempts.

When to call 911 or go to the emergency department

911 and the emergency department are appropriate when: a teen has made a suicide attempt, has a specific plan and the means to carry it out, is actively harming themselves and cannot be stopped, is in psychosis and cannot be engaged, is threatening harm to others, or is unconscious. National data on youth mental health emergency department visits show that these presentations have increased significantly in recent years, and emergency departments are equipped to conduct psychiatric evaluations and provide stabilization 3Ref 3Bommersbach TJ, McKean AJ, Olfson M, Rhee TG (2023).National trends in mental health-related emergency department visits among youth, 2011–2020.Youth mental-health ED visits rose from 7.7% to 13.1% of all visits 2011–2020; suicide-related visits increased ~5x; fewer than 20% of presenting youth were evaluated by a mental-health professional in the ED. If there is any uncertainty about immediate safety, erring toward emergency services is reasonable.

What to say (and not say) in the moment

Asking a teen directly whether they are thinking about suicide does not increase risk — this is a longstanding clinical misconception that has been studied directly 2Ref 2American Academy of Child and Adolescent Psychiatry (2024).Suicide in Children and Teens (Facts for Families No. 10).Suicide is the 2nd leading cause of death ages 15–24; warning signs including giving away possessions and sudden calm after depression; directly asking about suicidal thoughts is recommended. Direct, calm questions ('Are you thinking about killing yourself?') give the teen permission to tell the truth. Avoid minimizing ('you have so much to live for'), bargaining ('promise me you won't'), or expressions of anger. Stay present, stay as calm as possible, and stay with the teen while getting help. Remove access to means (medications, sharp objects) if it can be done safely — lethal means restriction is a clinically important step and saves lives.

After the acute crisis: what comes next

After an acute crisis, safety planning with a mental health clinician is typically the next step — this is a written plan the teen helps create, identifying warning signs, coping strategies, people to contact, and steps to take before the next crisis. Ongoing therapy and sometimes medication are part of the follow-up. The period immediately after a crisis and after discharge from a hospital or emergency department is a higher-risk time — close follow-up and maintained connection matter 3Ref 3Bommersbach TJ, McKean AJ, Olfson M, Rhee TG (2023).National trends in mental health-related emergency department visits among youth, 2011–2020.Youth mental-health ED visits rose from 7.7% to 13.1% of all visits 2011–2020; suicide-related visits increased ~5x; fewer than 20% of presenting youth were evaluated by a mental-health professional in the ED. Families with a teen who has recently been hospitalized should expect an outpatient appointment within days, not weeks. Parents also need support during this time, and family therapy or parent consultation can be helpful.